Chronic Fatigue Syndrome VA Rating Guide

Overview

A complex disorder characterized by extreme fatigue that cannot be explained by an underlying medical condition. A Gulf War presumptive condition, also associated with various infections and toxic exposures during service.

• VA Disability Code: 6354
• ICD Code: R53.82
• Category: Immune

Rating Percentages & Criteria

100% Rating

Criteria: Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care.

Examples:

• Cannot perform daily activities
• Requires assistance for self-care
• Bedridden frequently

60% Rating

Criteria: Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms which are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year.

Examples:

• Major activity restriction
• Frequent incapacitation
• Cannot work full-time

40% Rating

Criteria: Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms which restrict routine daily activities to less than 50 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year.

Examples:

• Significant activity restriction
• Regular incapacitating episodes
• Major work limitations

20% Rating

Criteria: Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year.

Examples:

• Moderate activity restriction
• Some incapacitating episodes
• Work difficulties

10% Rating

Criteria: Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms which wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication.

Examples:

• Mild symptoms with occasional flares
• Controlled with treatment

Symptoms & Functional Impact

Common symptoms associated with this condition:

• Extreme fatigue not relieved by rest
• Post-exertional malaise
• Unrefreshing sleep
• Cognitive difficulties (brain fog)
• Muscle pain
• Joint pain without swelling
• Headaches
• Sore throat or tender lymph nodes

Evidence Requirements for Your Claim

To support your claim, gather the following evidence:

• Medical records documenting diagnosis
• Documentation of Gulf War service (if claiming presumptive)
• Records showing other conditions ruled out
• Treatment records
• Personal statement on functional limitations

Secondary Conditions Commonly Connected

This condition often leads to secondary disabilities:

Depression (Strong Connection)

CFS commonly causes depression due to chronic debilitation

Fibromyalgia (Strong Connection)

CFS and fibromyalgia frequently co-occur

Sleep Apnea (Moderate Connection)

Sleep disorders often accompany CFS

Compensation & Pension (C&P) Exam Tips

Prepare for your C&P exam with these strategic tips:

• Document your daily activity limitations in detail
• Track periods of incapacitation
• Explain cognitive symptoms (brain fog, memory issues)
• Describe post-exertional malaise
• Bring documentation ruling out other conditions

Frequently Asked Questions

Is CFS a Gulf War presumptive condition?

Yes. Veterans who served in Southwest Asia may claim CFS as a presumptive condition.

How do I prove CFS when there's no definitive test?

CFS is diagnosed by excluding other conditions and meeting symptom criteria. Detailed documentation of symptoms and their impact is essential.

Key Points for Your Claim

When filing for Chronic Fatigue Syndrome:

1. Document everything - Every medical visit, treatment, and symptom counts
2. Get a nexus letter - A medical opinion linking your condition to service is crucial
3. Be thorough - Don't downplay your symptoms in your claim
4. Track progression - Show how the condition has worsened over time
5. Claim secondary conditions - Chronic Fatigue Syndrome often causes other disabilities

Ready to File Your Claim?

The VA disability system is complex, but you don't have to navigate it alone. We help veterans understand their benefits, gather strong evidence, and maximize their ratings.

Related Rating Guides:

• Depression VA Rating Guide
• Fibromyalgia VA Rating Guide
• Sleep Apnea VA Rating Guide